Individual provider Active NPI

Luis Rosero

  • Physical Therapist
  • West Orange, NJ
National Provider Identifier
1063846202
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01510700 Issued in NJ
Practice address
769 Northfield Ave
Suite 132
West Orange, NJ 07052-1198
Phone
(973) 669-3500
Fax
(973) 669-3444
NPI assigned
Aug 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01510700 NJ Primary

Addresses

Primary practice location

769 Northfield Ave
Suite 132
West Orange, NJ 07052-1198

Mailing address

11 Eagle Rock Ave
East Hanover, NJ 07936-3167
Phone (973) 887-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130919000473 NJ Practitioner - Physical Therapist in Private Practice 3779727482 Reassigns benefits to 3 organizations
I20221223000530 NY Practitioner - Physical Therapist in Private Practice 3779727482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostix Physical Therapy and RehabilitationGroup PAC ID 3971922568, 7 clinicians
United Sports Care and Physical TherapyGroup PAC ID 9436324886, 41 clinicians
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

Pompton Lakes, NJ 07442
Phone (201) 247-5426

197 Ridgedale Ave
Cedar Knolls, NJ 07927-2111
Phone (973) 605-5111

769 Northfield Ave
Suite 132
West Orange, NJ 07052-1106
Phone (973) 669-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01510700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostix Physical Therapy and Rehabilitation Physical Therapist CurrentSince Sep 6, 2023 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince Aug 26, 2013 Accepting new patients
Sportscare Physical Therapy of Ny, P.C. Physical Therapist CurrentSince Nov 1, 2022 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Jun 1, 2015 Accepting new patients
Sportscare Institute, Inc. Physical Therapist PastSince Aug 26, 2013 Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

11 Eagle Rock Ave
Ste 103
East Hanover, NJ 07936
Phone (973) 887-0115

769 Northfield Ave
Ste 132
West Orange, NJ 07052
Phone (973) 669-3500

2 Perlman Dr
Spring Valley, NY 10977
Phone (845) 371-2032

2 Crosfield Ave
West Nyack, NY 10994
Phone (212) 725-8511

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1063846202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 NORTHFIELD AVE",
            "address_2": "SUITE 132",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521198",
            "telephone_number": "973-669-3500",
            "fax_number": "973-669-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSERO",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01510700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.